Comparison of open Vs closed haemorrhoidectomy in the management of haemorrhoids

Background: haemorrhoidectomy is the treatment of choice for 3rd and 4th degree haemorrhoids. open haemorrhoidectomy is the conventional methods of haemorrhoidectomy. closed haemorrhoidectomy has been advocated in certain centres. aim: to compare the two methods of haemorrhoidectomy,closed and open types,considering operating time,hospital stay,healing,post operative complications and analgesic requirements in the management of hemorrhoids. study design: this was a quasi experimental study. setting: surgical unit-i,sir ganga ram hospital,lahore. study period: one year (from 17/03/2005 to16/03/2006). sampling size: the study included 100 patients of 3rd and 4th degree haemorrhoids. methods: one hundred age and sex matched patients suffering from 3rd and 4th degree haemorrhoids were studied. they were randomly divided into two groups; group 1 and group 2. group 1 underwent open haemorrhoidectomy. group 2 underwent closed haemorrhoidectomy. they were followed up post operatively in the ward and on outdoor basis. operating time,hospital stay,healing,post operative complications and analgesic requirements noted with each technique and compared. results: the mean age at presentation was 39.45+13.50. fifty six (56%) patients were females and 46 (46%) were males. closed technique took more operating time (mean operating time 28.40+3.00 min.) than open technique (mean operating time 31.50±2.20min.). healing was rapid in closed haemorrhoidectomy. both techniques were associated with mild degree of pain post operatively. there was no other statistical difference in both techniques. conclusion: closed technique resulted in rapid wound healing but took more operating time. statistically insignificant difference in hospital stay,post operative pain and complications between two techniques was found. both techniques were equally effective in the management of haemorrhoids.